• Title/Summary/Keyword: Urinary Calculi

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Two Case Report of Treatment by Closed Prescrotal Urethrotomy in Two Dogs with Urethral Calculi (폐쇄식 고환앞 요도절개술을 통한 요도결석견 치유 2례)

  • 정순욱;이충헌;신영규
    • Journal of Veterinary Clinics
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    • v.16 no.2
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    • pp.501-505
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    • 1999
  • Two dogs were presented urinary disorder in the associated with urolithiasis. Clinical signs were increased frequency of urination with mild straining pollakiuria, general depression and anorexia. On physical examinations, the pain was revealed at the palpation of the urethral area. Urinalysis showed high specific gravity, high pH, and triple phosphates. Radiography showed an increased radiopacity, and ultrasonography showed hyperecho in the just behind of os penis. Urolithiasis was diagnosed on the basis of clinical signs, radiography, and ultrasonography. In the prescrotal urethrotomy, urethra on the midline was incised and uroliths were eliminated. After elimination of uroliths, incision area was closed with 4-0 synthetic absorbable suture. In postoperative, there was good prognosis without hemorrhage, inflammation, and urethral stricture.

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General Anesthesia for Extracorporeal Shockwave Lithotripsyin Child with Lesch-Nyhan Syndrome (Lesch-Nyhan 증후군을 가진 소아의 체외충격파신쇄석술을 위한 전신마취 경험)

  • Park, Sang-Jin;Kwon, Il-Chi;Lee, Won-Ki;Lee, Deok-Hee
    • Journal of Yeungnam Medical Science
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    • v.25 no.1
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    • pp.78-83
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    • 2008
  • Lesch-Nyhan syndrome is an inborn error of purine metabolism resulting from hypoxanthine-guanine-phosphoribosyltransferase (HGPRT) deficiency and leading to excess purine production and uric acid over-production. It is a very rare X-linked recessive disorder, characterized by movement disorder, cognitive deficits, and self-injurious behavior. However, because of the high incidence of calculi, patients may present for surgery of urinary tract, and have increased risk of difficult intubation, aspiration pneumonia, renal insufficiency or sudden death. We report the case of a 5-year-old boy with Lesch-Nyhan syndrome who underwent successive extracorporeal shockwave lithotripsy under general anesthesia.

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Characteristic Plain Radiographic and Intravenous Urographic Findings of Bladder Calculi Formed over a Hair Nidus: A Case Report

  • Hak Jong Lee;Seung Hyup Kim
    • Korean Journal of Radiology
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    • v.2 no.1
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    • pp.61-62
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    • 2001
  • We present the characteristic plain radiographic and intravenous urographic (IVU) findings of calculus formed over a hair. A 66-year-old man who had been quadriplegic for 40 years because of vertebral injury was admitted for further evaluation of frequent urinary tract infection. Plain radiography showed a linear, serpiginous calcification in the lower abdomen, and IVU revealed a round filling defect with linear radiopacity in the bladder, suggesting calculus. The gross appearance of the stone after extraction demonstrated that calcification had formed over a hair.

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Unenhanced Spiral CT in Acute Ureteral Colic: A Replacement for Excretory Urography?

  • Jeong-Ah Ryu;Bohyun Kim;Yong Hwan Jeon;Jongmee Lee;Jin-Wook Lee;Seong Soo Jeon;Kwan Hyun Park
    • Korean Journal of Radiology
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    • v.2 no.1
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    • pp.14-20
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    • 2001
  • Objective: To compare the usefulness of unenhanced spiral CT (UCT) with that of excretory urography (EU) in patients with acute flank pain. Materials and Methods: Thirty patients presenting with acute flank pain underwent both UCT and EU. Both techniques were used to determine the presence, size, and location of urinary stone, and the presence or absence of secondary signs was also evaluated. The existence of ureteral stone was confirmed by its removal or spontaneous passage during follow-up. The absence of a stone was determined on the basis of the clinical and radiological evidence. Results: Twenty-one of the 30 patients had one or more ureteral stones and nine had no stone. CT depicted 22 of 23 calculi in the 21 patients with a stone, and no calculus in all nine without a stone. The sensitivity and specificity of UCT were 96% and 100%, respectively. EU disclosed 14 calculi in the 21 patients with a stone and no calculus in eight of the nine without a stone. UCT and EU demonstrated secondary signs of ureterolithiasis in 15 and 17 patients, respectively. Conclusion: For the evaluation of patients with acute flank pain, UCT is an excellent modality with high sensitivity and specificity. In near future it may replace EU.

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Treatment of Prostatic Calculus Causing Urinary Retention in a Dog (개에서 발생한 뇨 저류에 의한 전립선 결석의 치료)

  • Park, Chul-Ho;Oh, Ki-Seok;Son, Chang-Ho
    • Journal of Veterinary Clinics
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    • v.30 no.6
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    • pp.503-505
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    • 2013
  • A cross breed dog (6-year-old, 6 kg, intact male) was referred with hematuria. The dog had been treated for years owing to the urinary bladder calculi. On abdominal radiography, prostatic calculus was demonstrated in the prostatic area. In addition, ultrasonography and computed tomography (CT) scan would confirm that the part of calculus protruded within the prostatic urethra. The patient underwent a prostatolithotomy and traumatic prostatic urethra was carefully sutured and the omentum was filled with the prostate lumen. A crystallographic analysis of the stone showed 80% magnesium ammonium phosphate (struvite) and 20% carbonate apatite. The leakage of the urine was not observed post-operation and the hematuria improved and there was no specific problem at the 6 months follow-up.

Long-term Outcomes of Augmentation Cystoplasty in a Pediatric Population With Refractory Bladder Dysfunction: A 12-Year Follow-up Experience at Single Center

  • Mehmood, Shahbaz;Alhazmi, Hamdan;Al-Shayie, Mohammed;Althobity, Ahmed;Alshammari, Ahmed;Altaweel, Waleed Mohamed;Almathami, Ahmed;Vallasciani, Santiago
    • International Neurourology Journal
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    • v.22 no.4
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    • pp.287-294
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    • 2018
  • Purpose: Augmentation cystoplasty (AC) is a surgical procedure used in adults and children with refractory bladder dysfunction, including a small bladder capacity and inadequate bladder compliance, and in whom conservative and medical treatment has failed. This study was aimed to determine the long-term outcomes of AC in children. Methods: A retrospective analysis was conducted of 42 patients (31 males; mean age, $14.2{\pm}6.2years$) who underwent AC for neurogenic and nonneurogenic bladder dysfunction, with a median $12.0{\pm}1.5years$ of follow-up. All patients underwent AC using the ileum with or without continent reconstruction. Pre-AC, concurrent, and post-AC procedures and complications were analyzed. Patients who underwent ureterocystoplasty, were lost to follow-up, or had less than 10 years of follow-up were excluded. The primary outcomes were the complication and continence rates, the post-AC linear rate of height and weight gain, and renal function. The Student t-test was used to evaluate between-group differences and the paired t-test was used to evaluate longitudinal changes in measured variables. Results: Renal function was stable or improved in 32 of 42 patients (76.2%), with a post-AC continence rate of 88.1%. Thirty patients (71.4%) required 72 procedures post-AC. There was no statistically significant difference in the mean percentile of height (P=0. 212) or weight (P=0.142) of patients in the pre- and post-AC periods. No cases of bladder perforation or malignancy were detected. Conclusions: We consider AC to be a safe and effective procedure that does not negatively affect future physical growth, while achieving a good rate of stable renal function. Patients need long-term follow-up to address long-term complications.

Low-dose intravenous ketamine versus intravenous ketorolac in pain control in patients with acute renal colic in an emergency setting: a double-blind randomized clinical trial

  • Sotoodehnia, Mehran;Farmahini-Farahani, Mozhgan;Safaie, Arash;Rasooli, Fatemeh;Baratloo, Alireza
    • The Korean Journal of Pain
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    • v.32 no.2
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    • pp.97-104
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    • 2019
  • Background: This study was conducted to compare the effectiveness of low-dose ketamine versus ketorolac in pain control in patients with acute renal colic presenting to the emergency department (ED). Methods: This is a double-blind randomized clinical trial. The initial pain severity was assessed using the numerical rating scale (NRS). Then, ketamine or ketorolac was administered intravenously at a dose of 0.6 mg/kg and 30 mg respectively. The pain severity and adverse drug reactions were recorded 5, 15, 30, 60, and 120 min thereafter. Results: The data of 62 subjects in the ketamine group and 64 patients in the ketorolac group were analyzed. The mean age of the patients was $34.2{\pm}9.9$ and $37.9{\pm}10.6\;years$ in the ketamine and ketorolac group, respectively. There was no significant difference in the mean NRS scores at each time point, except for the 5 min, between the two groups. Despite a marked decrease in pain severity in the ketamine group from drug administration at the 5 min, a slight increase in pain was observed from the 5 min to the 15 min. The rate of adverse drug reactions, including dizziness (P = 0.001), agitation (P = 0.002), increased systolic blood pressure (> 140 mmHg), and diastolic blood pressure (> 90 mmHg) was higher in the ketamine group. Conclusions: Low dose ketamine is as effective as ketorolac in pain management in patients with renal colic presenting to the ED. However, it is associated with a higher rate of adverse drug reactions.

Comparison of Northgate SD-3 and Modulith SLX Lithotriptors: Treatment Results with 2,000 Renal and Ureteral Stones (Northgate SD-3와 Modulith SLX 쇄석기를 이용한 체외충격파쇄석술의 비교분석: 단일 신결석 및 요로결석 2,000례의 치료결과 분석)

  • Lee, Jun-Young;Jung, Hee-Chang;Moon, Ki-Hak;Cho, Chul-Kyu;Park, Tong-Choon
    • Journal of Yeungnam Medical Science
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    • v.16 no.1
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    • pp.85-93
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    • 1999
  • Some reports have shown a decreased effectiveness of extracorporeal shock wave lithotripsy(ESWL) with newer lithotriptors. We compared the treatment results of ESWL with a second generation Northgate SD-3 and a third generation Modulith SLX device. A total of 2,000 patients underwent ESWL treatments for single urinary calculus between September, 1988 and July, 1998. 1,241 patients were treated with Northgate SD-3 between September, 1988 and December, 1995. And 759 patients were treated with Modulith SLX between January, 1996 and July 1998. The treatment results were compared using chi-square test to determine statistical significance. The overall success rate, success rate according to the location and size, the mean number of sessions, complication rate and retreatment rate were calculated, according to lithotriptor. The overall success rate was 90.6% with Northgate SD-3 and 89.1% with Modulith SLX. With Northgate SD-3 and Modulith SLX, the success rate according to the location was 91.0%(579/636) and 88.1%(236/268) in kidney: 93.2%(517/555) and 89.9%(258/287) in upper ureter: 83.3%10/12) and 94.4%167/177) in middle and lower ureter: 47.4%(18/38) and 55. 6%(15/27) in staghorn stone, respectively. The success rate according to the size of stone with Northgate SD-3 and Modulith SLX for stones with the size under 10mm was 96.1%(612/637) and 93.1%(470/505); from 11mm to 20mm was 87.3%(421/482) and 86.4%(165/191); from 21mm to 30mm, 77.5%(62/80) and 67.5%(23/34): and for stones larger than 31mm was 69%(29/42) and 62.1%(18/29), respectively. Mean number of sessions for successful fragmentation was 1.21 and 1.69, respectively with Northgate SD-3 and Modulith SLX. Retreatment rate was 16.7% and 17.5%, respectively. The complications after treatment were severe pain(6.2% with Northgate SD-3 vs. 2.0% with Modulith SLX), steinstrasse(3.4% vs. 1.9%), fever(1.2% vs. 0.5%) and perirenal hematoma(0.2% vs. 0%) in order of frequency. There was no significant difference in the effectiveness of Northgate SD-3 and Modulith SLX. However, a statistically significant difference was observed between the two lithotriptors. We concluded that ESWL with Modulith SLX is more safe compared to Northgate SD-3.

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